title: Cardiac complications of oncologic therapy.
abstract: As survival rates continue to increase for patients with childhood and adult malignancies, imaging utilization in these patients will likely increase substantially. It is important to detect disease recurrence and to recognize the potential complications that occur after treatment with oncologic medications and therapeutic radiation. The most common cardiotoxic side effect of the anthracycline drug class is a dose-dependent decline in ejection fraction, which may result in dilated cardiomyopathy. Multiple-uptake gated acquisition (MUGA) scanning plays an important role in diagnosis of this subclinical cardiac dysfunction. Other less common cardiotoxic side effects of chemotherapeutic medications include arrhythmia, myocarditis, coronary artery disease, tamponade, pericarditis, and pericardial effusion. Radiation therapy can also lead to cardiotoxicity when the heart or pericardium is included in the radiation portal. Radiation-induced conditions include pericardial disease, coronary artery disease, valvular disease, and cardiomyopathy. Many of these side effects are asymptomatic until late in the course of the disease. With imaging, these pathologic conditions can often be diagnosed before symptom onset, which may allow early intervention. Radiologists should be familiar with the current knowledge and pathophysiology regarding cardiac complications related to chemotherapy and radiation therapy of malignant neoplasms and the appearances of treatment-related cardiotoxicity that can be found at radiography, nuclear medicine examinations, and cross-sectional imaging. Supplemental material available at http://radiographics.rsna.org/lookup/suppl/doi:10.1148/rg.336125005/-/DC1.
authors.affiliation: Department of Radiology, University of Washington Medical Center, Box 357115, 1959 NE Pacific St, Seattle, WA 98195.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Walker
authors.forename: David A
authors.initials: DA
authors.lastname: Saldaña
authors.forename: Gregory W
authors.initials: GW
authors.lastname: Gladish
authors.forename: Demetrius L
authors.initials: DL
authors.lastname: Dicks
authors.forename: Gregory
authors.initials: G
authors.lastname: Kicska
authors.forename: Lee M
authors.initials: LM
authors.lastname: Mitsumori
authors.forename: Gautham P
authors.initials: GP
authors.lastname: Reddy
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000209:etiology*; D003952:Diagnostic Imaging; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D011878:Radiotherapy / Q000009:adverse effects*
chemical_list: D000970:Antineoplastic Agents